Help us serve you better! Name * First Name Last Name Pronouns * Email * Phone * (###) ### #### Zip Code * Please answer the optional demographic questions to join our raffle giveaway! Your input helps us continue programs, celebrate diversity, and ensure everyone feels represented. Age Group Please select your age group from the options Under 18 18-24 25-34 35-44 45-54 55-64 65-75 75-80 80-90 90-99 100+ Gender Identity Please let us know how you identify Sexual Orientation Please let us know how you identify Race/Ethnicity Please check all that apply Native American or Indigenous Black or African American Hispanic or Latino/a/x Asian White North African Middle Eastern Multiracial/Mixed Race Thank you for
